Individual provider Active NPI

Katheryn Kolker

  • Physician Assistant
  • North Liberty, IA
National Provider Identifier
1063377018
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1765 Lininger LN
North Liberty, IA 52317-2335
Phone
(319) 665-3053
NPI assigned
Dec 22, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X IA Primary

Addresses

Primary practice location

1765 Lininger LN
North Liberty, IA 52317-2335

Mailing address

2315 Landon Rd Apt 307
North Liberty, IA 52317-6513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260403001635 IA Practitioner - Physician Assistant 9335624691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Physician Associates IncGroup PAC ID 1355242496, 103 clinicians

Practice addresses (Care Compare)

1765 Lininger LN
Suite 1
North Liberty, IA 52317-2336
Phone (319) 665-3053

300 W May St
Marengo, IA 52301-1261
Phone (319) 642-5543

Hospital & facility affiliations

  • Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1766361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1063377018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 LANDON RD APT 307",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523176513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 LININGER LN",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523172335",
            "telephone_number": "319-665-3053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLKER",
        "first_name": "KATHERYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-22",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, IA

Sources for this page

Verify at the official NPI Registry.